SARAH MICHELLE LIVE REVIEW
STUDY GUIDE (COMPLETE)
What is the screening tool for the thyroid? ✔️Ans - TSH Level
What is the normal range for TSH? ✔️Ans - 0.5-5.0
When do you order a full thyroid profile? ✔️Ans - If thyroid screening of
TSH comes back abnormal, then we will reorder TSH and T3, T4.
What disorder demonstrates a low TSH level and high T3 and T4 levels?
✔️Ans - Hyperthyroidism
What disorder demonstrates a high TSH level and low T3 and T4 levels?
✔️Ans - Hypothyroidism
What medication is used to treat hypothyroidism? ✔️Ans - Levothyroxine
(Synthroid)
What dose of Synthroid do you want to start your patient on? ✔️Ans - If
patient is elderly or if they have a significant cardiac history then we are going
to start at a lower dose of 12.5-25 mcg po daily.
In a normal healthy patient, we will start at 25-50 mcg po daily.
After initiation of medication for treatment of hypothyroidism, when do you
recheck TSH level? ✔️Ans - 6-8 weeks
When TSH level is stabilized, how often do you recheck their level? ✔️Ans -
Every 6-12 months
What is the go to medication for treatment of hyperthyroidism? ✔️Ans -
Tapazole and PTU
How do you manage treatment for hyperthyroidism in a pregnant patient?
✔️Ans - We need to use PTU instead if they are in their first trimester. After
first trimester, then they can be switched to tapazole.
,What medication class is used to treat symptoms of hyperthyroidism? ✔️Ans
- Beta-blockers- these help manage tachycardia and palpitations
What are 2 other treatments for the hyperthyroidism? ✔️Ans -
Thyroidectomy and radioactive iodine
What labs are used to measure and evaluate kidney function? ✔️Ans - GFR,
BUN, Creatinine
What lab value is most accurate description of kidney function? ✔️Ans -
GFR- this is going to tell us how the kidneys are filtering the blood and how
well they are removing waste.
What is a normal GFR value? ✔️Ans - >90
What GFR value indicates an absolute need to start a patient on dialysis?
✔️Ans - <15- this means that patient is in CKD stage 5
What is the second most important lab value to measure kidney function?
✔️Ans - Creatinine
What is creatinine? ✔️Ans - A waste product in the blood. If your kidneys
are functioning properly, then this waste product is removed by your kidneys.
When kidney function decreases, your creatinine level starts to rise.
What is a normal creatine value? ✔️Ans - Around 1
Why is BUN least telling for kidney function? ✔️Ans - Blood urea nitrogen
is a normal waste product when your body breaks down urea. However, this is
not specific to the kidneys. It can also indicate liver issues.
What is a normal BUN level? ✔️Ans - 10-20
With which first-line BP medication do we want to check the BUN/Cr? ✔️Ans
- ACE Inhibitors
What finding on a UA id indicative of true kidney damage? ✔️Ans - Casts-
WBC or RBC casts always need to be referred out
,When do we screen for microalbumin in the urine? ✔️Ans - We're always
going to screen when DM and HTN is first diagnosed.
What are the most common causes of CKD? ✔️Ans - HTN and DM
Why is it important to perform early screening for microalbumin in the urine?
✔️Ans - Patients who have mild kidney damage do not have symptoms, this
screening will ideally identify damage early and prevent progression.
What stage of CKD do patients show true symptoms? ✔️Ans - Stage 3 or
worse
How often are we screening for micro albumin? ✔️Ans - Bare minimum is
going to be annually for patients with DM or HTN or both.
What is the normal range of microalbumin? ✔️Ans - < 30
What is the most common symptom of all anemias? ✔️Ans - Fatigue
What is a normal hemoglobin level? ✔️Ans - 12-18
Women are on the lower end, and men are on the higher end
What is a normal hemoglobin to hematocrit ratio? ✔️Ans - 3 to 1
36-54%
What does MCV stand for? ✔️Ans - mean corpuscular volume
What is a normal MCV? ✔️Ans - 80-100
What does low MCV indicate? ✔️Ans - Microcytic anemias
What is the most common microcytic anemia? ✔️Ans - Iron deficiency
anemia
What is the biggest risk faction for the development of IDA is int he first year
of life? ✔️Ans - The ingestion of cow's milk
What does high MCV levels indicate? ✔️Ans - Microcytic anemia
, What are the most common microcytic anemias? ✔️Ans - B12 and folate
What symptoms are common with B12 deficiency anemia? ✔️Ans - Neuro
symptoms- the most common symptom is parasthesia
What surgery typically leads to B12 deficiency anemia? ✔️Ans -
Gastrectomy patients- who have part of their stomach removed
Why do gastrectomy patients typically have B12 deficiency anemia? ✔️Ans -
In order for B12 to be absorbed, it needs to be able to combine with intrinsic
factor, which is produced in the stomach. If we remove a large portion of the
stomach then we lose a lot of that intrinsic factor.
What diabetes medication used long term can also lead to B12 deficiency?
✔️Ans - Metformin
What is an abnormal lead level? ✔️Ans - >5, ideally no lead should be
within the body
What kind of symptoms may lead intoxication lead to? ✔️Ans - Cognitive
delays and behavioral problems
What are the 3 microcytic anemias? ✔️Ans - LIT
Lead
Iron
Thalassemia
What are the 2 macrocytic anemias? ✔️Ans - FAB
Folate and B12
What are the components of a lipid profile? ✔️Ans - Total cholesterol
HDl
LDL
Triglycerides
What's a normal total cholesterol level? ✔️Ans - <200
What is a normal HDL level? ✔️Ans - 40-60, the higher the better
STUDY GUIDE (COMPLETE)
What is the screening tool for the thyroid? ✔️Ans - TSH Level
What is the normal range for TSH? ✔️Ans - 0.5-5.0
When do you order a full thyroid profile? ✔️Ans - If thyroid screening of
TSH comes back abnormal, then we will reorder TSH and T3, T4.
What disorder demonstrates a low TSH level and high T3 and T4 levels?
✔️Ans - Hyperthyroidism
What disorder demonstrates a high TSH level and low T3 and T4 levels?
✔️Ans - Hypothyroidism
What medication is used to treat hypothyroidism? ✔️Ans - Levothyroxine
(Synthroid)
What dose of Synthroid do you want to start your patient on? ✔️Ans - If
patient is elderly or if they have a significant cardiac history then we are going
to start at a lower dose of 12.5-25 mcg po daily.
In a normal healthy patient, we will start at 25-50 mcg po daily.
After initiation of medication for treatment of hypothyroidism, when do you
recheck TSH level? ✔️Ans - 6-8 weeks
When TSH level is stabilized, how often do you recheck their level? ✔️Ans -
Every 6-12 months
What is the go to medication for treatment of hyperthyroidism? ✔️Ans -
Tapazole and PTU
How do you manage treatment for hyperthyroidism in a pregnant patient?
✔️Ans - We need to use PTU instead if they are in their first trimester. After
first trimester, then they can be switched to tapazole.
,What medication class is used to treat symptoms of hyperthyroidism? ✔️Ans
- Beta-blockers- these help manage tachycardia and palpitations
What are 2 other treatments for the hyperthyroidism? ✔️Ans -
Thyroidectomy and radioactive iodine
What labs are used to measure and evaluate kidney function? ✔️Ans - GFR,
BUN, Creatinine
What lab value is most accurate description of kidney function? ✔️Ans -
GFR- this is going to tell us how the kidneys are filtering the blood and how
well they are removing waste.
What is a normal GFR value? ✔️Ans - >90
What GFR value indicates an absolute need to start a patient on dialysis?
✔️Ans - <15- this means that patient is in CKD stage 5
What is the second most important lab value to measure kidney function?
✔️Ans - Creatinine
What is creatinine? ✔️Ans - A waste product in the blood. If your kidneys
are functioning properly, then this waste product is removed by your kidneys.
When kidney function decreases, your creatinine level starts to rise.
What is a normal creatine value? ✔️Ans - Around 1
Why is BUN least telling for kidney function? ✔️Ans - Blood urea nitrogen
is a normal waste product when your body breaks down urea. However, this is
not specific to the kidneys. It can also indicate liver issues.
What is a normal BUN level? ✔️Ans - 10-20
With which first-line BP medication do we want to check the BUN/Cr? ✔️Ans
- ACE Inhibitors
What finding on a UA id indicative of true kidney damage? ✔️Ans - Casts-
WBC or RBC casts always need to be referred out
,When do we screen for microalbumin in the urine? ✔️Ans - We're always
going to screen when DM and HTN is first diagnosed.
What are the most common causes of CKD? ✔️Ans - HTN and DM
Why is it important to perform early screening for microalbumin in the urine?
✔️Ans - Patients who have mild kidney damage do not have symptoms, this
screening will ideally identify damage early and prevent progression.
What stage of CKD do patients show true symptoms? ✔️Ans - Stage 3 or
worse
How often are we screening for micro albumin? ✔️Ans - Bare minimum is
going to be annually for patients with DM or HTN or both.
What is the normal range of microalbumin? ✔️Ans - < 30
What is the most common symptom of all anemias? ✔️Ans - Fatigue
What is a normal hemoglobin level? ✔️Ans - 12-18
Women are on the lower end, and men are on the higher end
What is a normal hemoglobin to hematocrit ratio? ✔️Ans - 3 to 1
36-54%
What does MCV stand for? ✔️Ans - mean corpuscular volume
What is a normal MCV? ✔️Ans - 80-100
What does low MCV indicate? ✔️Ans - Microcytic anemias
What is the most common microcytic anemia? ✔️Ans - Iron deficiency
anemia
What is the biggest risk faction for the development of IDA is int he first year
of life? ✔️Ans - The ingestion of cow's milk
What does high MCV levels indicate? ✔️Ans - Microcytic anemia
, What are the most common microcytic anemias? ✔️Ans - B12 and folate
What symptoms are common with B12 deficiency anemia? ✔️Ans - Neuro
symptoms- the most common symptom is parasthesia
What surgery typically leads to B12 deficiency anemia? ✔️Ans -
Gastrectomy patients- who have part of their stomach removed
Why do gastrectomy patients typically have B12 deficiency anemia? ✔️Ans -
In order for B12 to be absorbed, it needs to be able to combine with intrinsic
factor, which is produced in the stomach. If we remove a large portion of the
stomach then we lose a lot of that intrinsic factor.
What diabetes medication used long term can also lead to B12 deficiency?
✔️Ans - Metformin
What is an abnormal lead level? ✔️Ans - >5, ideally no lead should be
within the body
What kind of symptoms may lead intoxication lead to? ✔️Ans - Cognitive
delays and behavioral problems
What are the 3 microcytic anemias? ✔️Ans - LIT
Lead
Iron
Thalassemia
What are the 2 macrocytic anemias? ✔️Ans - FAB
Folate and B12
What are the components of a lipid profile? ✔️Ans - Total cholesterol
HDl
LDL
Triglycerides
What's a normal total cholesterol level? ✔️Ans - <200
What is a normal HDL level? ✔️Ans - 40-60, the higher the better
